Adult urologyImpact of comorbidity on health-related quality of life in men undergoing radical prostatectomy: Data from CaPSURE
Section snippets
Material and methods
We drew subjects from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a longitudinal, observational prostate cancer disease registry that includes patients with biopsy-proven adenocarcinoma from 40 urology practices nationwide. Subjects submit semiannual HRQOL questionnaires until death or withdrawal from the study. All participants provided informed consent before study enrollment. Additional details of the project method have been previously reported.9
All subjects
Results
The 856 men included in this analysis were of similar age and marital status as other men receiving RP who were not included in the analysis. However, the men in this analysis were more educated, had higher incomes, were more likely to be white, and had a lower risk of disease than other men undergoing RP.
These 856 men contributed 3140 questionnaires (or 3.7 per person) permitting us to examine longitudinal changes in HRQOL. The median follow-up time after surgery was 16 months (range 3 to 30).
Comment
We began the study with two hypotheses. First, we hypothesized that men with more comorbid conditions would have worse HRQOL than men without comorbidities at baseline, and we found this to be true. Our second hypothesis was that these differences would be maintained over time; here our findings were mixed. In almost all cases, the HRQOL scores for men with comorbidities were worse at each point, and this difference was constant over time.
However, for sexual function and the physical component
Conclusions
Men with more comorbidities have a worse quality of life before and after RP. However, with two exceptions, the HRQOL scores declined at similar rates in men with and without comorbidities. In addition, specific comorbidities, such as hypertension, heart disease, GI disease, and urinary conditions, were associated with declines in particular HRQOL domains.
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The current CaPSURE Investigators are listed in the Appendix.
CaPSURE is supported by TAP Pharmaceutical Products Incorporated, Lake Forest, IL. This research was additionally funded by the National Institutes of Health/National Cancer Institute University of California, San Francisco SPORE Specialized Program of Research Excellence grant P50 C89520.
E. P. Elkin, P. L. Marr, D. M. Latini, M. S. Litwin, and P. R. Carroll are study investigators partially funded by the sponsor of this study, TAP Pharmaceutical Products Inc. M. S. Litwin is also a paid consultant to Sanofi-Synthelabo and Amgen. P. R. Carroll is also a paid consultant to AstraZeneca, Steba Biotech NV, Predicant Biosciences, and Watson Pharmaceuticals and is a meeting participant/lecturer for the International Center for Post-Graduate Medical Education.